Ick, Ick, Ick, ER episode last night...

[AugustLia23]

I am getting so sick of the way they dramatize labor and delivery on TV. I have been trying not to watch too many "births" on TV, so as not to get it into my head that what they are showing is the norm.

But I was watching ER last night and they had a delivery. a women, 38 weeks along, fell down a few floors, then went into labor. They had her flat on her back in the emergency room, legs straight up in the air, and pushing. They get the head out, then Abby or Neela finds that the shoulders are stuck. The woman asks what is going on, and she says "your baby is a little bit too big for your pelvis. Maybe if they had her sitting up even a little bit so that the baby didn't have the uphill battle to get out. At the end, the episiotomy, saved the day and the 8lb 10oz(HUGE, I know! ) is delivered in good condition.

Also on The L Word season finale, Tina is planning a homebirth, but of course it doesn't go as planned and the baby ends up passing meconium and needs to be rushed to the emergency room via ambulance to be sectioned out! I saw no place where the meconium was causing such a big problem, but what do I know?

Sorry for the rant...

[MrsMoe]

It's to create drama, for entertainment... but it is sad because it also creates/enforces stereotypes...

[pamamidwife]

oh, god, I love the L word. I'm so disappointed. Sheez.

[Belle]

At least with the Lost episode when she gave birth a couple months back she didn't have any problems. She did refuse to push for awhile becaue (in her in labor logic, I sympathize with) she didn't want to have the baby there. She gave birth sitting up too. They did dramatise it though by having her attendants not know what to do and act flustered.

[NewYearsEve04]

I saw that ER episode as well and was thinking of course she is having problems coming out look at the position she is in. I thought....I wonder if they changed her position if it would help. I'm sure at that point changing positions would have been hard as she was exhausted and just fell through all those floors but all of the people in the ER could have helped. I can't imagine being in a situation like that in the ER and feeling helpless because of the high intensity enviroment. I pray that nothing like that happens to any of us.

[liseux]

This is being discussed in the TV forum too. It was a symphysisiotomy that saved the day, not an episiotomy. It made me mad because these just aren`t done anymore because they caused way too many problems. Pamamidwife, maybe you know more about those procedures, I was told they aren`t even taught these days.
Its also not 100 % successful in severe s. dystocia to do a Gaskin maneuver, but its pretty close, so they should have at least mentioned it.

[EmmaJean]

what do tv writers know about birth? They'r just trying to get the most shock value, like the one resident's comment "You're going to do a section right here??" Ugh. It was comical to me to see her legs STRAIGHT in the air trying to push. Birth on ER is always a MAJOR event! Remember Julianna Magulise's character and her crazy twin birth?! That was a mess... Oh, not to mention ER's very first episode was a horrible horrible birth...

[navessa]

i was getting worked up watching that last nite as well. i kept saying to the tv "get her on all fours!" (with so many of them in the room, they could have easily help her).

i too am curious about symphysisiotomy. does someone know how it is done?

i heard that ER uses real medical personnel to help make the scenes more real. so it is scary that they portray it that way.

[MonicaS]

Originally Posted by navessa

i was getting worked up watching that last nite as well. i kept saying to the tv "get her on all fours!" (with so many of them in the room, they could have easily help her).

i too am curious about symphysisiotomy. does someone know how it is done?

Symphysiotomy: A surgical procedure to effect an immediate dramatic increase in the size of the pelvic outlet to permit delivery of a baby. The cartilage of the symphysis pubis (where the pubic bones come together) is surgically divided in the procedure which can be a life-saver for the baby.

Can you say, OUCH?!!

I too was yelling at the TV to put her on all fours. : My poor DH.

[teachinmaof3]

I thought the same things.

However I also wondered, if you were in the ER and had a head injury (as that character obivously did w/ the bleeding from the ears) and trauma, they aren't going to get you in a different position.

[pamamidwife]

I just don't get why so many babies are delivered in the ER. with a big hospital like that, you'd think that there would be some room or some providers on site. gawd.

[MamaTaraX]

I watched it too and actually was going to post about it when I got on here today First I was appalled at this woman's legs straight up in the air. Then I was semi-happy with the almost crotch shot. Then I was yelling when they said there was shoulder dystocia. I literally yelled "put her on all fours!!" Obvbiously that didn't happen. Then they said the thing abou tit had been 8 minutes already and myDH says "there went the 8 minute rule" (referring to getting a shoulder dystocia out in 8 minutes preferably). So they do a symphisotomy (sp?) and I wasshocked. Nobody does those anymore!! I even heard some people talking about a midwife (I wish I could rememebr the exact term they used for her) that does this still and how appalled people were about it, including a mom who had it done to her. ANyway, to make it all complete, all the staff was congratulating the dr. on her "good episiotomy". It wasn't an episiotomy!!! *duh* *slinking over to the TV forum where I've never been befroe*
Namaste,Tara

[AugustLia23]

Oh, is that what they did. I only really heard iostomoy, and assumed it eas the epis. kind. That's even worse!! I've never heard of that before, but it sounds awful!

[runes]

i :LOL when later on in the episode, when Abby was filling out charts, that she didn't even know if she spelled symphysisiotomy correctly and she had to ask Neela.

and i also was yelling at the tv...get her on all fours. i think that would have been really interesting for mainstream america to see and certainly as dramatic as a surgical procedure, imho!!

[robugmum]

I originally thought the reason she had to be on her back was because she was strapped to a spinal board, but that wasn't it. I too, was wishing they could have had her turn onto her hands and knees! I was so wanting Abby to use Gaskin's name and suggest it! She did ask Neela about some manouvre but I missed the name, did anyone get it?

[mmaramba]

I was totally going to post about this one, too. Aaaaaarrrrgggghhhhhh!

And the -otomy was the only thing that, you know, finally saved the day!

Everyone who saw this and has SD issues is going to think this is the way they are solved. Sad, but true. Just like all the women who watch "A Baby Story" and think they're now well-informed WRT birth.

I will say that they had her legs up like that to do McRoberts, if I'm not mistaken. I did a little research last night and came up with this:

http://www.swedish.org/19962.cfm

Note that even this article doesn't believe episiotomy, etc. is usually helpful for SD... except to "allow more room for hands/instruments." And that's not really considered to be a good enough reason.

Hmmm.... Letter-writing campaign? Letters-to-the-editor?

[angelpie545]

Things like this are exactly the reason why I don't watch ER anymore......one time I was watching ER and they had a woman having an unltrasound and she had one of the oxygen things on.......ya know with the little tiny tubes that go in your nose??? Talk about dramatic. I've had a total of 5 ultrasounds between two pregnancies and I have NEVER had to wear an oxygen thingy.........wow. I know that they do those things for drama, ext. though. It's in their best interest, see they got all of us to yell at the TV? That's what they want. People to either watch it cause they love it, or watch it cause they hate it and want to point out all the things that are unrealisitc, ext. Either way they get the ratings they want. The ratings are high, and the show goes on.

[2+twins]

What's The L Word? :

[tinyshoes]

I love closed-captioning...that's why I can tell you that the maneuver Neela was sqwaking about was the Wood-Screw Maneuver, which yes, is funny, because yes, it should be the McRoberts (but how could that woman have gotten her a$$ more in the air?) or the Gaskin maneuver. (Side note: Googling Wood-Screw Maneuver results in many lawsuit-looking URLs, and I saw this litigation tidbit at Contemporary OB/GYN citing lawsuit details:
The plaintiffs' experts testified that appropriate responses to shoulder dystocia might have included (1) episiotomy; (2) draining the mother's bladder; (3) pressure above the mother's pubic bone in a rocking fashion; (4) McRobert's maneuver; and (5) the Wood's screw maneuver.

Anyway....just thought that was funny, that Abby's idea was last on this list.

I'll play the ER storyline game...was that laboring mother really at risk for a spine injury at that time? Because I don't think she was at risk at that point in the story. I saw her neck up and no immobilzer around her neck.

HOW was it possible for that laboring woman to maintain her legs at a 90 degree angle during the entire "delivery"? We know that the baby had been stuck for 8 minutes......I am suprised that she didn't tire and accidently lower her legs, changing position, thereby increasing her pelvic outlet.

And if Abby knows some screwy ancient symphopubic cutting procedure--which I had NEVER EVER EVER HEARD of until last night---and I like to think I'm pretty darn aware, hydataform mole, blastocyst...all sorts of Level 2 Birth Junkie data is floating around in my brain....

HOW could she not know the mundane SQUAT to widen the pelvis fact??!?!?!

That's the actual beef with medical innacuracies in that episode. Not even that it was bs that a woman gave birth with her legs in the air in the ER. Okay, fine, of course!!!!!! But that Abby would know some super-wierd cutting procedure and not a squatting one.

OR that Abby wouldn't do a pudendal block before her symphopub slice!!!!!

Why didn't they share the grizzly details of the generous episiotomy you know Neela cut? It's all about the gore, right?

FRANKLY, in this 28% c-section rate culture, the TRULY dramatic, unusual, bizarre, other-worldly TV-worthy thing to have happened would have been for Abby to walk into that trauma room and say to the laboring mother, hey, just get on your hands and knees, and you can push this baby out--just take a deep breath, and push when you feel the urge.

THAT would have been amazing and shocking for our Babies R Us scheduled c-section mainsteam.

OTHER birthing beef from last night's episode......

remember when Carter was taking care of that 10-year-old black girl (dont' remember her ailment) and the parents came in and were all, YOU delivered her, Dr. Carter, it was you, she was premature, and it was you who delivered her, right in the ER, blah blah blah.

I hollered to dh, it was like she was saying, "Hey--I was just that pregnant lady there, WITNESSING YOUR DELIVERY of this child." GEEEEEEEEZ......so his sloppy med student self was in the vicinity.....take a little CREDIT...you created and then EXPELLED this baby Dr. Carter Delivered.

okay....I think I'm done venting now.

And for the record, I'm sure every single element of ER is this annoying AT ALL TIMES for everyone in every field that is depectied. Social work, RNs, the patients themselves, etc...it must be really painful, for everyone. Seriously--I just always think about how covered in hair those ER patients must be......because NO MD or RN ever has their hair back; it's always falling ever-so-beautifully and gently....and directly into the chest tube or whatever it is their slicing.

[amydidit]

I'll be honest, I wasn't terribly surprised when they didn't change her position... she was just in a serious accident and hadn't appeared to be in the ER long enough for them to assess her condition well... for all they knew she could've had other injuries that would've made it dangerous for them to change her position. Just another side thought there.

And I too would like to know what The L Word is?